The effect of vitamin A fortification of sugar on the serum vitamin A levels of preschool Guatemalan children: a longitudinal evaluation

Arroyave, G; Mejía, Luis A.; Aguilar, J R

doi:10.1093/ajcn/34.1.41

Cited by 91 publications

(62 citation statements)

References 10 publications

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“…32,33 Costa Rica and El Salvador also had improvements in vitamin A status, presumably as a consequence of the implementation of national sugar fortification programs. 12,14,33 On the other hand, an increase in the prevalence of vitamin A deficiency was observed in the only two South American countries where data were collected before and after 1998 (Ecuador and Colombia). The highest rates of deficiency in these two countries are found among the most disadvantaged and economically vulnerable groups, indigenous people and people of African descent.…”

Section: Discussionmentioning

confidence: 99%

“…In Guatemala, the introduction of fortification of sugar with retinyl palmitate in 1975 resulted in a substantial increase in vitamin A status one year after the program's implementation. 12 El Salvador, Honduras, and Nicaragua later implemented national sugar fortification programs because of its cost-effectiveness. 33 As shown by the most recent surveys, Guatemala (prevalence 0.3% in 2010, a decrease of 15.5 percentage points from 1995) and Nicaragua (prevalence 0.7% in 2005, a decrease of 30.3 percentage points from 1993) essentially eliminated vitamin A deficiency; El Salvador was the country with the highest reduction in prevalence, with a decrease of 31.0 percentage points.…”

Section: Discussionmentioning

confidence: 99%

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Interpretation of Serum Retinol Data From Latin America and the Caribbean

et al. 2015

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Background: In recent decades, the general socioeconomic situation in Latin America and the Caribbean countries has improved, and many vitamin A programs have been implemented in an attempt to reduce vitamin A deficiency in the region. Objective: To examine vitamin A status in Latin America and the Caribbean based on serum retinol concentrations and to contrast available data published before and after 1998. Methods: A systematic review was performed. National surveys or representative studies that reported vitamin A status were selected. Results: Ten national surveys and six representative studies were identified. Data for children under 6 years of age indicate that Guatemala and Nicaragua have practically eradicated vitamin A deficiency (less than 2% prevalence of serum retinol < 20 mg/dL). In Costa Rica, Cuba, El Salvador, and Panama, the prevalence of vitamin A deficiency ranged from 2.8% to 9.4%. In Peru, Honduras, Argentina, Ecuador, and Brazil, vitamin A deficiency is a moderate public health problem (prevalence from 14.0% to 17.4%), while in Colombia, Mexico, and Haiti it is a severe public health problem (prevalence from 24.3% to 32.0%). Disadvantaged groups (indigenous people and those of Afro-Colombian descent) have the highest rates of deficiency. The prevalence of vitamin A deficiency is under 20% in schoolchildren and adult women. When data published before and after 1998 for children under 6 years of age were compared, most Central American countries had a reduction in the prevalence of vitamin A deficiency (p < .05), whereas in South American countries, the prevalence of vitamin A deficiency increased over time (p < .05). Conclusions: The prevalence of vitamin A deficiency in children under 6 years of age has decreased in many Central American countries, but vitamin A deficiency still remains a public health problem in numerous Latin America and Caribbean countries, especially among disadvantaged and vulnerable groups. Because of issues with the accuracy of the serum retinol biomarker reflecting body stores, these results must be interpreted with caution.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Interpretation of Serum Retinol Data From Latin America and the Caribbean

et al. 2015

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“…Therefore, food fortification to combat vitamin A deficiency seems preferable for the current situation. Some studies have shown that fortification of condiments such as monosodium glutamate 29 , sugar 30 and wheat 31 with vitamin A considerably improved vitamin A status. However, vitamin A-fortified monosodium glutamate in Indonesia was not favourable since it changed the colour and increased the price of the product.…”

Section: Discussionmentioning

confidence: 99%

Vitamin A capsule distribution to control vitamin A deficiency in Indonesia: effect of supplementation in pre-school children and compliance with the programme

Pangaribuan

Erhardt

Scherbaum

et al. 2003

Public Health Nutr.

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Objective: The aim of this study was to evaluate the effectiveness of a widespread vitamin A supplementation programme and to describe indicators of compliance with the programme in Indonesia. Design: Prospective cohort study. Children's anthropometric data were gathered at baseline (June 2000) and 4 months later (2 months after supplementation in August 2000). Serum retinol, haemoglobin, ferritin, a 1 -acid glycoprotein and C-reactive protein were measured at baseline and at follow-up. Caregivers of the children were interviewed using a questionnaire. Setting: Semi-urban and rural areas of Semarang district, Central Java, Indonesia. Subjects: Children ðn ¼ 400Þ aged 1-5 years. Results: After the supplementation, the proportion of children with a low concentration of retinol decreased in recipients from 18.8 to 14.5%. However, in non-recipients, the prevalence of vitamin A deficiency increased from 31.9 to 37.5%, this prevalence being significantly higher than in recipients. A significant decrease occurred in the proportion of recipients with low ferritin (26.5 to 16.2%) and haemoglobin (25.7 to 15.3%), whereas the proportions did not show a significant change after supplementation for non-recipients. Modest linear growth was detected in recipients after supplementation but there was no effect on ponderal growth. The coverage rate of the supplementation in the study areas was 60%. There was an association between compliance of the caregivers and their knowledge about the potential benefit of vitamin A supplementation, the place where sick children were taken and age of the children. Conclusions: The vitamin A supplementation programme marginally decreased the proportion of vitamin A deficiency and had a marginal effect on the nutritional status of recipients. More than one micronutrient intervention is needed to increase the effectiveness of the supplementation programme. To increase compliance and coverage in the supplementation programme, nutrition communication and private healthcare practices need to be included in the programme.

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“…A combination of fortification and capsule distribution would be more effective 59 . Sugar 60 or cookies 60,62 fortification led to an increase in vitamin A and plasmatic retinol levels in children, especially in those whose basal levels were below 20µg/dl 60,61 , reducing the percentage of children with inadequate liver vitamin A reserves 61,63 . The fortification of cookies with β-carotene at a level of 50% of the RDA was sufficient to maintain the concentration of plasmatic retinol on a daily basis, but not during long vacation periods, in primary school children 62 .…”

Section: The Nutritional Importance Of Fortified Foods Vitamin Amentioning

confidence: 99%

Fortification of industrialized foods with vitamins

Liberato

Pinheiro-Sant’Ana

2006

Rev. Nutr.

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A B S T R A C TVitamins are essential to life. Inadequate eating habits, high caloric intake and metabolic defects lead to micronutrient deficiencies, affecting more than two billion people worldwide. The increasing intake of industrialized foods, combined with low vitamin stability has led to the common practice of adding these nutrients to processed foods. This review discusses the terminology, availability, intake and risk of hypervitaminosis, due to the intake and nutritional importance of foods fortified with vitamins. The addition of nutrients should occur in foods that are effectively consumed by the target population and must meet the real needs of a significant segment of the population. In Brazil, a total of 166 products available in supermarkets are vitamin-enriched. A 10-year study involving children and adolescents in Germany showed that 90% of those surveyed used at least one fortified food. During this 10-year period, 472 fortified products were consumed. The enrichment of foods should be based on the needs of each country and, if possible, regional needs. For instance, in order to increase its intake, Vitamin D is added to foods in Denmark during the winter, mainly for the elderly. However, in Brazil, there is no evidence of the need to fortify food with this vitamin. A survey showed that of the 76 enriched dairy products, 37 contained vitamin D. Food-fortification is a very important strategy to solve nutritional deficiency problems, but it can also cause many health problems.Indexing terms: food, fortified; food habits. R E S U M O

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The effect of vitamin A fortification of sugar on the serum vitamin A levels of preschool Guatemalan children: a longitudinal evaluation

Cited by 91 publications

References 10 publications

Interpretation of Serum Retinol Data From Latin America and the Caribbean

Interpretation of Serum Retinol Data From Latin America and the Caribbean

Vitamin A capsule distribution to control vitamin A deficiency in Indonesia: effect of supplementation in pre-school children and compliance with the programme

Fortification of industrialized foods with vitamins

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